α-Defensin point-of-care test for diagnosis of prosthetic joint infections: Neglected role of laboratory and clinical pathologists

Lorenzo Drago, Marco Toscano, Lorenza Tacchini, Giuseppe Banfi

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

Periprosthetic joint infection (PJI) is a serious complication that may occur after native joint replacement leading to a severe health and economic burden. Currently, due to several confounding factors, PJI is difficult to diagnose. Today, a multidisciplinary approach is indispensable to correctly define a periprosthetic joint infection; indeed, tissue histology, microbiology cultures and clinical findings are used together to achieve this goal. Analysis of α-defensin is commonly used for PJI diagnosis, as it allows the rapid detection of α-defensin present in the synovial fluid following a microbial infection. Currently, a point-of-care testing (POCT) assay able to detect the presence of human α-defensins 1-3 in synovial fluid of patients is aimed directly at orthopedic surgeons. However, many orthopedic surgeons lack experience and training in quality laboratory practices, often failing to appreciate the significance of quality control and proper documentation when using POCT assays. To guarantee the highest quality diagnostic services, the α-defensin test should be used together with other biochemical and microbiological criteria commonly used for PJI diagnosis. Additionally, the close cooperation and communication between laboratory, pathologists and physicians is of fundamental importance in the correct diagnosis of PJI.

Original languageEnglish
Pages (from-to)19-24
Number of pages6
JournalClinical Chemistry and Laboratory Medicine
Volume56
Issue number1
DOIs
Publication statusPublished - Nov 27 2017

Fingerprint

Point-of-Care Systems
Defensins
Prosthetics
Joints
Orthopedics
Infection
Assays
Microbiology
Synovial Fluid
Histology
Fluids
Testing
Replacement Arthroplasties
Quality control
Diagnostic Services
Health
Tissue
Economics
Pathologists
Communication

Keywords

  • clinical outcome
  • periprosthetic joint infection
  • point-of-care testing
  • α-defensin

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

α-Defensin point-of-care test for diagnosis of prosthetic joint infections : Neglected role of laboratory and clinical pathologists. / Drago, Lorenzo; Toscano, Marco; Tacchini, Lorenza; Banfi, Giuseppe.

In: Clinical Chemistry and Laboratory Medicine, Vol. 56, No. 1, 27.11.2017, p. 19-24.

Research output: Contribution to journalReview article

@article{447a3f97cd234bb4b1601a7a490e3e4e,
title = "α-Defensin point-of-care test for diagnosis of prosthetic joint infections: Neglected role of laboratory and clinical pathologists",
abstract = "Periprosthetic joint infection (PJI) is a serious complication that may occur after native joint replacement leading to a severe health and economic burden. Currently, due to several confounding factors, PJI is difficult to diagnose. Today, a multidisciplinary approach is indispensable to correctly define a periprosthetic joint infection; indeed, tissue histology, microbiology cultures and clinical findings are used together to achieve this goal. Analysis of α-defensin is commonly used for PJI diagnosis, as it allows the rapid detection of α-defensin present in the synovial fluid following a microbial infection. Currently, a point-of-care testing (POCT) assay able to detect the presence of human α-defensins 1-3 in synovial fluid of patients is aimed directly at orthopedic surgeons. However, many orthopedic surgeons lack experience and training in quality laboratory practices, often failing to appreciate the significance of quality control and proper documentation when using POCT assays. To guarantee the highest quality diagnostic services, the α-defensin test should be used together with other biochemical and microbiological criteria commonly used for PJI diagnosis. Additionally, the close cooperation and communication between laboratory, pathologists and physicians is of fundamental importance in the correct diagnosis of PJI.",
keywords = "clinical outcome, periprosthetic joint infection, point-of-care testing, α-defensin",
author = "Lorenzo Drago and Marco Toscano and Lorenza Tacchini and Giuseppe Banfi",
year = "2017",
month = "11",
day = "27",
doi = "10.1515/cclm-2017-0041",
language = "English",
volume = "56",
pages = "19--24",
journal = "Clinical Chemistry and Laboratory Medicine",
issn = "1434-6621",
publisher = "Walter de Gruyter GmbH",
number = "1",

}

TY - JOUR

T1 - α-Defensin point-of-care test for diagnosis of prosthetic joint infections

T2 - Neglected role of laboratory and clinical pathologists

AU - Drago, Lorenzo

AU - Toscano, Marco

AU - Tacchini, Lorenza

AU - Banfi, Giuseppe

PY - 2017/11/27

Y1 - 2017/11/27

N2 - Periprosthetic joint infection (PJI) is a serious complication that may occur after native joint replacement leading to a severe health and economic burden. Currently, due to several confounding factors, PJI is difficult to diagnose. Today, a multidisciplinary approach is indispensable to correctly define a periprosthetic joint infection; indeed, tissue histology, microbiology cultures and clinical findings are used together to achieve this goal. Analysis of α-defensin is commonly used for PJI diagnosis, as it allows the rapid detection of α-defensin present in the synovial fluid following a microbial infection. Currently, a point-of-care testing (POCT) assay able to detect the presence of human α-defensins 1-3 in synovial fluid of patients is aimed directly at orthopedic surgeons. However, many orthopedic surgeons lack experience and training in quality laboratory practices, often failing to appreciate the significance of quality control and proper documentation when using POCT assays. To guarantee the highest quality diagnostic services, the α-defensin test should be used together with other biochemical and microbiological criteria commonly used for PJI diagnosis. Additionally, the close cooperation and communication between laboratory, pathologists and physicians is of fundamental importance in the correct diagnosis of PJI.

AB - Periprosthetic joint infection (PJI) is a serious complication that may occur after native joint replacement leading to a severe health and economic burden. Currently, due to several confounding factors, PJI is difficult to diagnose. Today, a multidisciplinary approach is indispensable to correctly define a periprosthetic joint infection; indeed, tissue histology, microbiology cultures and clinical findings are used together to achieve this goal. Analysis of α-defensin is commonly used for PJI diagnosis, as it allows the rapid detection of α-defensin present in the synovial fluid following a microbial infection. Currently, a point-of-care testing (POCT) assay able to detect the presence of human α-defensins 1-3 in synovial fluid of patients is aimed directly at orthopedic surgeons. However, many orthopedic surgeons lack experience and training in quality laboratory practices, often failing to appreciate the significance of quality control and proper documentation when using POCT assays. To guarantee the highest quality diagnostic services, the α-defensin test should be used together with other biochemical and microbiological criteria commonly used for PJI diagnosis. Additionally, the close cooperation and communication between laboratory, pathologists and physicians is of fundamental importance in the correct diagnosis of PJI.

KW - clinical outcome

KW - periprosthetic joint infection

KW - point-of-care testing

KW - α-defensin

UR - http://www.scopus.com/inward/record.url?scp=85037069583&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85037069583&partnerID=8YFLogxK

U2 - 10.1515/cclm-2017-0041

DO - 10.1515/cclm-2017-0041

M3 - Review article

C2 - 28708567

AN - SCOPUS:85037069583

VL - 56

SP - 19

EP - 24

JO - Clinical Chemistry and Laboratory Medicine

JF - Clinical Chemistry and Laboratory Medicine

SN - 1434-6621

IS - 1

ER -